PURPOSE: To evaluate the safety and efficacy of a preparative regimen consisting of fractionated total-body radiation (9.9 to 12 Gy) and melphalan (140 mg/m(2) in a single dose) in children with acute myeloid leukemia in first completeremission (CR) given autologous bone marrow transplantation (ABMT).PATIENTS AND METHODS: Fifty-three children (30 males and 23 females; age range,1.5 to 18 years) were enrolled onto the study. The median time from first CR toABMT was 3.5 months (range, 1.4 to 13 months), with 45 patients (85%) undergoing transplantation within 6 months from the diagnosis. Forty-five patients received in vitro marrow purging with standard-dose mafosfamide (100 microg/mL), sevenpatients were treated with interleukin-2 before marrow collection, and in theremaining child, the marrow was unmanipulated. The median infused cell dose was1.8 x 10(8)/kg (range, 0.4 to 5.8 x 10(8)/kg).RESULTS: All patients but one achieved hematopoietic engraftment, with a mediantime to neutrophil recovery of 24 days (range,11 to 66 days). Treatment-relatedtoxicity was moderate and consisted mainly of mucositis. One patient died fromcytomegalovirus interstitial pneumonia, and one died from pulmonary hemorrhage.Fourteen patients (26%) relapsed at a median time of 6 months after ABMT (range, 2 to 17 months), with a cumulative relapse probability of 29% (95% confidenceinterval, 16% to 42%). The 5-year Kaplan-Meier estimate of survival for all 53patients was 78% (range, 65% to 90%), whereas the overall 5-year disease-free survival was 68% (range, 55% to 81%), with a median follow-up duration of 40months (range, 7 to 130 months).CONCLUSIONS: These data suggest that, in our cohort of patients, the combination of total-body irradiation and melphalan is safe and associated with goodantileukemia activity, making ABMT an appealing alternative for postremissiontherapy in children with acute myeloid leukemia in first CR.

Total body irradiation, thiotepa, and cyclophosphamide as a conditioning regimen for children with acute lymphoblastic leukemia in first or second remission undergoing bone marrow transplantation with HLA-identical siblings

CESARO, SIMONE;
1999-01-01

Abstract

PURPOSE: To evaluate the safety and efficacy of a preparative regimen consisting of fractionated total-body radiation (9.9 to 12 Gy) and melphalan (140 mg/m(2) in a single dose) in children with acute myeloid leukemia in first completeremission (CR) given autologous bone marrow transplantation (ABMT).PATIENTS AND METHODS: Fifty-three children (30 males and 23 females; age range,1.5 to 18 years) were enrolled onto the study. The median time from first CR toABMT was 3.5 months (range, 1.4 to 13 months), with 45 patients (85%) undergoing transplantation within 6 months from the diagnosis. Forty-five patients received in vitro marrow purging with standard-dose mafosfamide (100 microg/mL), sevenpatients were treated with interleukin-2 before marrow collection, and in theremaining child, the marrow was unmanipulated. The median infused cell dose was1.8 x 10(8)/kg (range, 0.4 to 5.8 x 10(8)/kg).RESULTS: All patients but one achieved hematopoietic engraftment, with a mediantime to neutrophil recovery of 24 days (range,11 to 66 days). Treatment-relatedtoxicity was moderate and consisted mainly of mucositis. One patient died fromcytomegalovirus interstitial pneumonia, and one died from pulmonary hemorrhage.Fourteen patients (26%) relapsed at a median time of 6 months after ABMT (range, 2 to 17 months), with a cumulative relapse probability of 29% (95% confidenceinterval, 16% to 42%). The 5-year Kaplan-Meier estimate of survival for all 53patients was 78% (range, 65% to 90%), whereas the overall 5-year disease-free survival was 68% (range, 55% to 81%), with a median follow-up duration of 40months (range, 7 to 130 months).CONCLUSIONS: These data suggest that, in our cohort of patients, the combination of total-body irradiation and melphalan is safe and associated with goodantileukemia activity, making ABMT an appealing alternative for postremissiontherapy in children with acute myeloid leukemia in first CR.
1999
total body irradiation, acute myeloid leukemia, autologous stem cell transplant
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/779531
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus ND
  • ???jsp.display-item.citation.isi??? 40
social impact